Individual
TONYA MICHELLE CONRAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
505 W WOODLAND DR, FAIRFIELD, IL 62837-1059
(618) 842-2587
Mailing address
505 W WOODLAND DR, FAIRFIELD, IL 62837-1059
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160002439
IL
Other
Enumeration date
10/02/2009
Last updated
10/02/2009
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